Provider Demographics
NPI:1356676845
Name:BOGLE, ROBERT KENT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:KENT
Last Name:BOGLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7996
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33586-7996
Mailing Address - Country:US
Mailing Address - Phone:813-512-9373
Mailing Address - Fax:
Practice Address - Street 1:2404 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34691-3943
Practice Address - Country:US
Practice Address - Phone:727-945-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2009-0672208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery